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The Centers for Medicare & Medicaid Services (CMS) issued a final rule (CMS-1450-F) to update Medicare's Home Health Prospective
Payment System (HH PPS) payment rates and wage index for calendar year (CY) 2014. As required by Section 3131(a) of the Affordable
Care Act, this rule implements rebasing adjustments, with a 4-year phase-in, to the national, standardized 60-day episode
payment rates; the national per-visit rates; and the NRS conversion factor. Payments to home health agencies (HHAs) are estimated
to decrease by approximately 1.05 percent, or -$200 million in CY 2014, reflecting the combined effects of the 2.3 percent
HH payment update percentage ($440 million increase), the rebasing adjustments to the national, standardized 60-day episode
payment rate, the national per-visit payment rates, and the NRS conversion factor ($520 million decrease), and the effects
of ICD-9-CM HH PPS Grouper refinements ($120 million decrease). This final rule also discusses our transition to ICD-10-CM
coding, establishes home health quality reporting requirements for CY 2014 payment and subsequent years, specifies that Medicaid
responsibilities for home health surveys be explicitly recognized in the State Medicaid Plan, and revises the methodology
for calculating state Medicaid programs’ fair share of Home Health Agency (HHA) survey costs.

A draft list of Manifestation and Etiology codes is provided below in the Downloads section. The list is being provided for review and comments or questions regarding the list of manifestation and etiology codes will be accepted through December 30, 2013 via e-mail to grouperemail@mmm.com.